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All anaesthetists involved in the management of major trauma should understand the principles and techniques of haemorrhage control resuscitation to prevent the lethal diamond of hypothermia, acidosis, coagulopathy and hypocalcemia using low-volume fluid resuscitation, blood products and damage control surgery.^94,98,99

Children currently transition to adult congenital heart disease services at the age of 16–18 years, although transition services are integrated into the care pathway from 12 years of age. Anaesthetists should be aware of legislation and good practice guidance relevant to young and vulnerable adults.^35,41

Clinical governance is the responsibility of individual institutions and, for AAs, this should follow the same principles that apply to medically qualified anaesthetists, ensuring:¹⁵

• training that is appropriately focused and resourced
• supervision and support in keeping with practitioners’ needs and practice responsibilities
• practice centred audit and review processes.

To maintain the necessary knowledge and skills, vascular anaesthetists should have a regular commitment to the specialty. Adequate time must be made for them to participate in relevant MDT meetings and continuing professional development (CPD) activities. This should include the facility and resources to visit other centres of excellence to exchange ideas and develop new skills where appropriate.²⁸

Patients receiving emergency anaesthesia care in a non-theatre location should be cared for by anaesthetists with the same level of competency and assistance as those receiving emergency care in the theatre environment. Certain circumstances may require additional assistance; local arrangements should allow sufficient personnel and resources to support this assistance.^85,99

There should be an anaesthetist or a professional with suitably qualified airway skills who is available for patients in the PACU within three minutes.^10,11

Adequate recovery room facilities that comply with the Association of Anaesthetists’ recommendations for standards of monitoring during anaesthesia and recovery should be available within the delivery suite theatre complex.⁴³

Any scheduled burn lists should be organised and staffed by appropriately trained anaesthetists and surgeons who work regularly in that area and who have no conflicting clinical commitments.⁶²

Any scheduled burn lists should be organised and staffed by appropriately trained anaesthetists and surgeons who work regularly in that area and who have no conflicting clinical commitments.⁶³

A dedicated, skilled anaesthetic assistant should be available in all locations outside the operating theatre where anaesthesia is undertaken by an anaesthetist.^47,48